运动4小时再分布铊-201单光子发射计算机断层扫描及运动诱发ST段抬高在检测急性心肌梗死患者存活心肌中的应用

Exercise four hour redistribution thallium-201 single photon emission computed tomography and exercise induced ST segment elevation in detecting the viable myocardium in patients with acute myocardial infarction.

作者信息

Yamagishi H, Akioka K, Takagi M, Tanaka A, Takeuchi K, Yoshikawa J, Ochi H

机构信息

First Department of Internal Medicine, Osaka City University Medical School, Osaka, Japan.

出版信息

Heart. 1999 Jan;81(1):17-24. doi: 10.1136/hrt.81.1.17.

DOI:10.1136/hrt.81.1.17

PMID:10220539

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1728918/

Abstract

OBJECTIVE

To investigate the specificity and sensitivity of the combination of redistribution in exercise thallium-201 single photon emission computed tomography (SPECT) and exercise induced ST elevation for detecting the viable myocardium in patients with acute myocardial infarction.

DESIGN

37 patients were studied within seven weeks of onset of Q wave myocardial infarction (anterior in 22, inferior in 15). All patients underwent exercise four hour redistribution thallium-201 SPECT and positron emission tomography using fluorine-18-fluorodeoxyglucose (FDG) and nitrogen-13 ammonia under fasting conditions.

RESULTS

Sixteen patients showed exercise induced ST elevation >/= 1.5 mm, and 15 of these had increased FDG uptake in the infarct region. Eleven of 16 patients (10 of 11 patients with anterior infarctions) with irreversible thallium-201 defects and increased FDG uptake showed exercise induced ST elevation. The sensitivity, specificity, and predictive accuracy of redistribution, exercise induced ST segment elevation, or both for detecting increased FDG uptake were 82%, 75%, and 67% (94%, 75%, and 91% for anterior infarctions), respectively.

CONCLUSIONS

In patients with acute Q wave myocardial infarction, the combination of redistribution in exercise thallium-201 SPECT and exercise induced ST elevation can detect the viable myocardium in the infarct region with high sensitivity and specificity, especially in patients with anterior infarctions.

摘要

目的

研究运动负荷铊-201单光子发射计算机断层扫描（SPECT）中的再分布与运动诱发ST段抬高相结合检测急性心肌梗死患者存活心肌的特异性和敏感性。

设计

对37例在Q波心肌梗死发病7周内的患者进行研究（前壁梗死22例，下壁梗死15例）。所有患者在空腹状态下接受运动负荷4小时后铊-201 SPECT检查以及使用氟-18-氟脱氧葡萄糖（FDG）和氮-13氨的正电子发射断层扫描。

结果

16例患者出现运动诱发ST段抬高≥1.5mm，其中15例梗死区域FDG摄取增加。16例铊-201不可逆缺损且FDG摄取增加的患者中有11例（前壁梗死的11例患者中有10例）出现运动诱发ST段抬高。再分布、运动诱发ST段抬高或两者结合检测FDG摄取增加的敏感性、特异性和预测准确性分别为82%、75%和67%（前壁梗死分别为94%、75%和91%）。